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From: Franzen -Hill Inc. ol_.. n , .r ' To: 12094683433 Page: 5/6 Date: 4/18/2011 9:57:58 AM 0 Monitoring System Certification Page 2 of 4 12/07 F. In -Tank Gauging ! SIR Equipment E Check this box if tank gauging Is used only for inventory control. E Check this box If no tank gauging or SIR equipment is Installed. This section must be completed if in -tank gauging equipment Is used to perform leak detection monitoring. r`mmntata tha fntlnaeinn chncklket- E Yes E No* Has all input wiring been Inspected for proper entry and termination, including testing for ground fauits? E Yes E No* Were all tank gauging probes visually inspected for damage and residue buildup? E Yes E No* Was accuracy of system product level readings tested? E Yes E No* Was accuracy of system water level readings tested? E Yes E. No* Were all probes reinstalled properly? E Yes is No* I Were all items on the equipment manufacturer's maintenance checklist completed? In the section t1, betow, aescriae now ana when inese aenciencies were or Witi ne correcteu. G. Line Leak Detectors (LLD): E Check this box if LLDs are not installed. 11mmnlata tho #nlinwinn nhAckliat- X Yes No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all NIA that apply) Simulated leak rate: E 3 g.p.h.; E 0.1 g.p.h,, E 0.2 g.p.h. X Yes No* Were all LLDs confirmed operational and accurate within regulatory requirements? X Yes No* Was the testing apparatus properly calibrated? X Yes No* For mechanical LLDs, does the LLD restrict product flow If it detects a leak? NIA Yes No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? X NIA Yes NO* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled X NIA or Yes No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or X NIA fails a test? Yes No* For electronic LLDs, have all accessible wiring connections been visually Inspected? X NIA X Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? ° in the section H, beiow, describe now and when these aenctencies were or writ be correctea. H. Comments. Monitoring System Certification Page 3 of 4 12107 This fax was sent with GFI FAXmaker fax server. For more information, visit: http://www.gfi.com